Elm Ranch 1 LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

ELM RANCH 1 LLC

Doing business as

Elm Ranch 1

Practice address

9048 Elm Ave
Orangevale, CA 95662-3524

Phone

(916) 987-2954

Fax

(916) 987-1593

NPI assigned

Feb 12, 2009

Last updated

Feb 12, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Eduardo P Baltazar, RN

Title

President

Phone

(916) 293-1500

Specialties & licenses 1

Addresses

Other names 1

• ELM RANCH 1 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1609015783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7104 SANTA JUANITA AVE",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956622832",
            "telephone_number": "916-293-1500",
            "fax_number": "916-987-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9048 ELM AVE",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956623524",
            "telephone_number": "916-987-2954",
            "fax_number": "916-987-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELM RANCH 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "BALTAZAR",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-293-1500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELM RANCH 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jane E Eddy, P.A.
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• Amy Elizabeth Enright
• Nicholas Erickson
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• Eskaton Properties, Inc. (Eskaton FountainWood Lodge)
• Amy Lynn Fansler, D.C.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Orangevale, CA
• Providers in Orangevale, CA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.